American Speech-Language-Hearing Association
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Aphasia

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What is aphasia?

Aphasia is a communication disorder that results from damage to the parts of the brain that contain language (typically in the left half of the brain). Individuals who experience damage to the right side of the brain may have additional difficulties beyond speech and language issues. Aphasia may causes difficulties in speaking, listening, reading, and writing, but does not affect intelligence. Individuals with aphasia may also have other problems, such as dysarthria, apraxia, or swallowing problems.

What causes aphasia?

Aphasia is most often caused by stroke. However, any disease or damage to the parts of the brain that control language can cause aphasia. These include brain tumors, traumatic brain injury, and progressive neurological disorders.

What are some signs or symptoms of aphasia?

The specific symptoms and severity of aphasia vary depending on the location and extent of brain damage. Individuals with damage to the front part of the brain may have "choppy" or non-fluent speech. However, they can typically understand what people say fairly well. Those with damage to the posterior regions of the brain often have fluent speech—that is, the rate and rhythm of speech may sound normal. However, their speech may contain the wrong words or made-up words. They also typically have difficulty understanding what is spoken.

Additionally, all individuals with aphasia may also have one or more of the following problems:

  • Difficulty producing language:
    • Experience difficulty coming up with the words they want to say
    • Substitute the intended word with another word that may be related in meaning to the target (e.g., "chicken" for "fish") or unrelated (e.g., "radio" for "ball")
    • Switch sounds within words (e.g., "wish dasher" for "dishwasher")
    • Use made-up words (e.g., "frigilin" for "hamburger")
    • Have difficulty putting words together to form sentences
    • String together made-up words and real words fluently but without making no sense
  • Difficulty understanding language:
    • Misunderstand what others say, especially when they speak fast (e.g., radio or television news) or in long sentences
    • Find it hard to understand speech in background noise or in group situations
    • Misinterpret jokes and take the literal meaning of figurative speech (e.g., "it's raining cats and dogs")
  • Difficulty reading and writing:
    • Difficulty reading forms, pamphlets, books, and other written material
    • Problems spelling and putting words together to write sentences
    • Difficulty understanding number concepts (e.g., telling time, counting money, adding/subtracting)

How common is aphasia?

The National Institute on Neurological Disorders and Stroke estimates that approximately one million individuals suffer from aphasia in the United States.

How is aphasia diagnosed?

The speech-language pathologist (SLP) evaluates the individual with a variety tools to determine the type and severity of aphasia. It includes assessment of:

  • Auditory Comprehension: understanding words, questions, directions, and stories that are spoken
  • Verbal Expression: producing automatic sequences (e.g., days of the week), naming objects, describing pictures, responding to questions, and having conversations
  • Reading and Writing: understanding or producing letters, words, sentences, and paragraphs
  • Functional Communication: using gestures, drawing, pointing, or other supportive means of communication when he/she has trouble getting a point across verbally

What treatments are available for people with aphasia?

Find a Certified Speech-Language PathologistThere are many types of treatment available for individuals with aphasia. The type of treatment depends on the needs and goals of the person with aphasia. Treatment may be provided in individual or group sessions. The speech-language pathologist (SLP) works on activities to improve specific language skills affected by damage to the brain. The SLP also helps the person with aphasia develop and use strategies to improve overall communication in a variety of situations (e.g., life participation approach to the treatment of aphasia). Later on in recovery, the SLP may work with a vocational specialist to help the person return to work or school, if appropriate. The SLP may also work with employers and/or educational specialists to implement the use of compensatory strategies in these settings and may work with them to modify the environment to meet language needs.

How effective are treatments for aphasia?

ASHA produced a treatment efficacy summary on aphasia [PDF] that describes evidence about how well treatment works. This summary is useful not only to individuals with aphasia and their caregivers but also to insurance companies considering payment for much needed services for aphasia.

What can I do to communicate better with the person with aphasia?

  1. Get the person's attention before you start speaking.
  2. Maintain eye contact and watch the person’s body language and use of gesture.
  3. Minimize or eliminate background noise (TV, radio, other people).
  4. Keep your voice at a normal level. Do not speak loudly unless the person asks you to do so.
  5. Keep communication simple, but adult. Don't "talk down" to the person with aphasia.
  6. Simplify your sentence structure and emphasize key words. 
  7. Reduce your rate of speech.
  8. Give the individual time to speak. Resist the urge to finish sentences or offer words.
  9. Communicate with drawings, gestures, writing, and facial expressions in addition to speech.
  10. Encourage the person to use drawings, gestures, and writing.
  11. Use "yes" and "no" questions rather than open-ended questions.
  12. Praise all attempts to speak and downplay any errors. Avoid insisting that that each word be produced perfectly.
  13. Engage in normal activities whenever possible. 
  14. Encourage independence and avoid being overprotective.

What other organizations have information about aphasia?

This list is not exhaustive and inclusion does not imply endorsement of the organization or the content of the website by ASHA.

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